Paul V E, Shetty D P, Timmis A D
Department of Cardiology, Guy's Hospital, London, U.K.
Int J Cardiol. 1990 May;27(2):280-2. doi: 10.1016/0167-5273(90)90173-3.
A 65-year-old man presented with acute inferior myocardial infarction and received thrombolytic therapy with clinical evidence of coronary arterial recanalisation. Recovery was uncomplicated until- the eighth day when he experienced recurrent chest pain with evidence of reinfarction in the same territory. This was associated with the development of a pansystolic murmur and cardiogenic shock. Cardiac catheterisation showed right coronary arterial occlusion and inferior infarction with a false aneurysm and a left-to-right shunt (shunt ratio 2.5:1). Surgery confirmed the formation of a false aneurysm caused by rupture of the free walls of both ventricles. Importantly, however, the interventricular septum was intact and the left-to-right shunt was through the false aneurysm itself. This is the first report of biventricular free-wall rupture with shunting through a false aneurysm treated successfully by surgery.
一名65岁男性因急性下壁心肌梗死就诊，接受了溶栓治疗，有冠状动脉再通的临床证据。恢复过程顺利，直到第八天，他再次出现胸痛，同一区域有再梗死的证据。这与全收缩期杂音和心源性休克的出现有关。心导管检查显示右冠状动脉闭塞和下壁梗死，伴有假性动脉瘤和左向右分流（分流比2.5:1）。手术证实了由双心室游离壁破裂导致的假性动脉瘤的形成。然而，重要的是，室间隔完整，左向右分流是通过假性动脉瘤本身。这是首例经手术成功治疗的双心室游离壁破裂并通过假性动脉瘤进行分流的报告。
